| National Provider Identifier [NPI]: | 1982679411 |
| Last Name Of The Provider | SAG |
| First Name Of The Provider | RANDY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 S 8TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FERNANDINA BEACH |
| Zip Code Of The Provider | 320343067 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 2701 |
| Number Of Medicare Beneficiaries | 2359 |
| Total Submitted Charge Amount | 465622.84 |
| Total Medicare Allowed Amount | 103459.01 |
| Total Medicare Payment Amount | 77751.04 |
| Total Medicare Standardized Payment Amount | 73146.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 2701 |
| Number Of Medicare Beneficiaries With Medical Services | 2359 |
| Total Medical Submitted Charge Amount | 465622.84 |
| Total Medical Medicare Allowed Amount | 103459.01 |
| Total Medical Medicare Payment Amount | 77751.04 |
| Total Medical Medicare Standardized Payment Amount | 73146.6 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 559 |
| Number Of Beneficiaries Age 65 to 74 | 714 |
| Number Of Beneficiaries Age 75 to 84 | 627 |
| Number Of Beneficiaries Age Greater 84 | 459 |
| Number Of Female Beneficiaries | 1358 |
| Number Of Male Beneficiaries | 1001 |
| Number Of Non Hispanic White Beneficiaries | 1861 |
| Number Of Black or African American Beneficiaries | 379 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 932 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1128 |